Doc, The inside of my left knee hurts, Right on the knee cap. I take time off the bike so it feels better and then the next time I ride it hurts again. I went to the doctor and they don't know whats wrong, do you have an opinion? THanks, wink_________________Winkelmann Training Fundamentals-
Get the WTF Experience

Knee pain on the inside of the knee can be due to problems with the cleat position with too much toeing out of your feet, too much float requiring excessive foot rotation to exit the pedals or too much tension to exit the cleats. Additionally, the knee pain can be due to too much stress put on the underside of the knee cap from big gear mashing, cranks that are too long, a seat that is too low or too forward. Some individuals will experience knee pain to the inside of the knee if the feet are too far appart.

Check your cleat position. The cleats should allow your feet to go to their natural neutral position. Walk barefoot with wet feet on a carpeted floor or on bare concreate to see the angle of your feet when you walk. Position your cleats so they reproduce that angle of your shoes when they are clipped into the pedals without your feet in the shoes.

Keep the float of your pedals limited to 3 to 5 degrees. Adjust the release tension, if you are able, to allow easy entry and exit without undue stress on your knee joint. If you have fixed release tension, consider a new set of pedals that allow you to adjust the release tension.

If you find your feet are too widely spaced, you can shift the cleats on your pedals to the out side of your soles to bring the feet closer in. You could also try a narrower bottom bracket within the constraints of your bikes chainline and cranks to chainstays clearance.

Check your saddle hight and position. At bottom dead center of the crank stroke your leg should be bent at the knee to around 20 degrees for mountain biking (10 degrees for road biking) if you are bending your knees more than this then you will need to raise your saddle. Shorter crank arms will allow less bending of the knees at top dead center. This will decrease the stress on your knee cap. The shorter cranks will assist you in developing a smoother high speed cadence which is desirable for reducing knee stress.

Check the gearing on your bike. You may be able to get slightly lower gear rations such as a 12-34 rear cassette and/or a 20-32-42 chainring set-up front.

If you are still experiencing pain get a referral to a sports medicine physician who is familiar with bicyclists.

Thanks,_________________Paul K. Nolan, MD
AKA: The Bike Doc

Last edited by The Bike Doc on Wed Feb 18, 2004 5:47 am GMT +0000; edited 1 time in total

Thanks Doc, I havent switched my pedals or seat position. I have a new bike that has the same pedals/shoe combo and the seat height from the bottom bracket is the same as the old bike(the geometry is very close). I will check with the width. As with mashing, Ive been working on it but it feels so good to push the big ring. Thanks for the advice. -wink